Self-rated health as a predictor of mid-term and long-term mortality in older Afro-Caribbeans hospitalised via the emergency department

Godaert, Lidvine; Godard‐Sebillotte, Claire; Saint-Albin, L. Allard; Bousquet, Lionel; Bourdel-Marchasson, I.; Fanon, Jean-Luc; Dramé, Moustapha

doi:10.1007/s11136-017-1693-3

Cited by 9 publications

(14 citation statements)

References 31 publications

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“…Death rates were 4.6% in typical cases, 19.0% in atypical cases, 19.2% in severe acute cases and 23.5% in patients with unclassifiable cases. These rates are lower than those observed at 2 years in a general population of patients hospitalised in a geriatric ward without acute CVI . We observed a statistically significantly higher rate of death among patients who presented with unclassifiable forms of CVI, according to the WHO classification, than among patients with typical acute presentation.…”

Section: Discussioncontrasting

confidence: 73%

Long‐term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans

Godaert

Bartholet

Najioullah

et al. 2019

Tropical Med Int Health

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Objective To investigate whether the long‐term survival in elderly patients with prior Chikungunya virus infection (CVI) is associated with the clinical form presented in the acute phase, as defined by the WHO classification. Methods Retrospective cohort study performed in Martinique University Hospitals. Patients who attended the emergency department for suspected CVI, and who had a positive biological diagnosis of CVI by reverse transcription‐polymerase chain reaction on a plasma sample between 10 January and 31 December 2014 were eligible for inclusion. Time‐to‐death was the primary outcome. The independent relationship between clinical forms and time‐to‐death was analysed using a Cox model. Results In total, 268 patients were included. Mean age was 80 ± 8 years, 53% were women. Median length of follow‐up was 28 months (range: 0–39). During follow‐up, 53 (19.8%) patients died. Median survival time was 13.2 months (range: 0–33.6). At the end of follow‐up, death rates were 4.6% for acute clinical cases, 19.0% for atypical cases, 19.2% for severe acute cases and 23.5% for unclassifiable cases. By multivariable analysis, the clinical form of CVI at admission was found to be independently associated with long‐term survival (atypical form: HR = 2.38; 95% CI = 2.15–2.62; severe acute form: HR = 2.40; 95% CI = 2.17–2.64; unclassifiable form: HR = 2.28; 95% CI = 2.06–2.51). Conclusion The clinical form at presentation with CVI has a significant impact on long‐term survival. Management of CVI patients should be tailored according to their clinical form at admission.

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Section: Discussioncontrasting

confidence: 73%

Long‐term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans

Godaert

Bartholet

Najioullah

et al. 2019

Tropical Med Int Health

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“…To help the US healthcare system overcome the challenge of providing care for economically disadvantaged African American older adults with CMCs, we conducted the current study to test whether poor SRH is associated with increased risk of hospitalization and ED visits in this population. We were particularly interested in poor SRH which is shown to be a predictor of poor health [23], healthcare use [24], and mortality [25][26][27][28]. Although some studies have questioned the relevance of poor SRH for this population [29], other studies suggest that SRH is still predictive of health outcomes for African American older adults.…”

Section: Aimsmentioning

confidence: 99%

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Assari

Smith

Bazargan

2020

J. Racial and Ethnic Health Disparities

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Objectives We investigated the associations between poor self-rated health (SRH), hospitalization, and emergency department (ED) visits among African American older adults with diabetes mellitus (DM). Methods This survey recruited 235 non-institutionalized African American older adults (age > = 55 years) with diabetes mellitus (DM). Participants were recruited using a convenience sample from economically disadvantaged urban areas of South Los Angeles, California. Poor SRH was the independent variable. Hospitalization and ED visits in the past 12 months were the outcomes. Demographic factors, health [comorbid medical conditions (CMCs) and polypharmacy], health behaviors (smoking and drinking), and access (difficulty accessing care, dissatisfaction with the medical care, routine source of care, and visiting the same doctor) were confounders. Binary logistic regressions were used for data analysis. Results Poor SRH was associated with higher odds of hospitalization and ED visit, while all covariates were controlled. Conclusions Poor SRH may be predictive of increased healthcare utilization among African American older adults with DM. Research should test whether close monitoring of African American older adults with DM and poor SRH helps reduce their frequency of hospitalization and ED visits or not.

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“…Self-rated health (SRH) is a widely accepted indicator of overall health. Poor SRH predicts risk of mortality [1,2,3,4,5,6,7,8,9] in both community [10] and clinical [11] settings. For both the general population [10] and patients with a chronic disease [12], SRH reflects long-term risk of mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Although SRH is known to be a valid health measure [1,2,3,4,5,6,7,8,9], SRH may not reflect the same aspects of health across populations distinguished by race, ethnicity, and gender [39]. Although SRH is efficient, cost effective, and time saving [40], poor SRH may not have the same meaning for men as for women [41].…”

Section: Introductionmentioning

confidence: 99%

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Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

Assari

Smith

Bazargan

2019

IJERPH

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Background. Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective. To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods. This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results. In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion. Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

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Self-rated health as a predictor of mid-term and long-term mortality in older Afro-Caribbeans hospitalised via the emergency department

Abstract: Assessment of SRH could have implications for clinical practice, particularly in helping practitioners to better estimate prognosis in the acute care settings.

Cited by 9 publications

References 31 publications

Long‐term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans

Long‐term survival and clinical forms in the acute phase of Chikungunya virus infection in older Caribbeans

Poor Self-Rated Health Is Associated with Hospitalization and Emergency Department Visits in African American Older Adults with Diabetes

Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

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